Ovarian cancer is the second most common gynaecological cancer in the western world, and the leading cause of death from gynaecological malignancies [Dinh 2008]. Its estimated crude incidence in the European Union is close to 18/100,000 women/year and the mortality reaches 12/100,000 women/year [Vasey 2005]. Approximately 30,000 women die annually from ovarian cancer in Europe [Ferlay 2002]. Most of these cases affect women older than 50 years, and epithelial tumours account for over 90% of all ovarian cancers [Salzberg 2005;Colombo 2006].

Staging is described using the American Joint Committee on Cancer (AJCC) and the Federation Internationale de Gynecologie et d’Obstetrique (FIGO) classification guidelines (Table 1).

Approximately 75% of the cases present an advanced stage at the moment of the diagnosis due to the absence of overt signs or symptons in earlier-stage disease [Dinh 2008,Ozols 2005].

The mortality rate of ovarian cancer has slightly changed within the last 50 years, and long-term trends in cancer mortality reveal few encouraging advances in overall survival, possibly favoured by improved surgery and the use of new active drugs [Ferlay 2002].

Surgery can be curative when the disease is still confined to the ovary, and in these cases 5-year survival rates exceed 90%. However, as most patients present with intraperitoneal dissemination, survival rates drop to 20-25% [Ozols 2005]. Current standard primary therapy for advanced ovarian cancer involves maximal cytoreductive surgery followed by systemic platinum-based chemotherapy -usually carboplatin- combined with a taxane [Ozols 2005;Salzberg 2005;Colombo 2006;du Bois 2005]. Up to 80% of women with stage III/IV tumours respond to therapy, and 50% achieve a complete response. Despite these high initial response rates, results still remain far from satisfactory, as median time to progression (TTP) does not exceed 15-18 months, median survival is below 3 years, and 5-year survival rates are close to 30% [Vermorken 2008]. Furthermore, a large proportion of responding patients (50-75%) eventually relapse [Vermorken 2008].

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